Scale it Up ? the title of our U19 proposal--addresses the process of improving self- management including: 1) the identification and implementation of interventions that are effective for improving self-management in at-risk and HIV+ youth; and 2) the assessment of the five components of self-management as a synergistic model across the U19 projects, and how these components vary over time, are directly improved by interventions, and mediate intervention effects. The Management Core for Scale It Up will provide oversight, management, and coordination of all research and core-related activities. The Management Core will be responsible for site monitoring, fiscal management, institutional review processes, data safety monitoring, and community involvement, as well as for recruitment, enrollment, retention, and data management. The specific aims are Aim #1: Establish, communicate, maintain, review, and change, as needed, the scientific priorities of Scale It Up in collaboration with other members of our U19, community involvement (Youth Community Advisory Board, YCAB), members of other funded ATN U19s, and NICHD and other NIH entities; Aim #2: Establish and implement a continuous assessment and feedback loop, between the Research Projects, the Cores, the YCAB and the other funded U19s, designed to establish and sustain a strong collaborative environment. Aim #3: Provide effective and timely financial management, fiscal accountability, and administrative support for Scale It Up, including Research Projects, clinical sites, and Cores, and take responsibility for resource management and adjustment of resource allocations for the duration of the U19 funding period; Aim #4: Provide scientific and oversight support for the Analytic Core (AC) and the Implementation Science Core (ISC); Aim #5: Establish and manage a Clinical Site Management Center (CMSC) which will be responsible for site performance monitoring, community involvement (including the establishment and support of a national YCAB), institutional review process/regulatory affairs, and data safety monitoring. Aim #6: Establish and manage a Recruitment and Enrollment Center (REC) which will be responsible for project management, data management, and recruitment and retention support.